The headline quote comes from a front-page article this week on CNNMoney news website relating how doctors in the US are quitting medicine because of money woes. Meanwhile here in the UK we see headlines that doctors in Primary Care here are overpaid. Having spent some time recently with a bunch of enterprising ophthalmic surgeons and practice managers I was struck by the tensions between care for the patient and commercial success – tensions that every health service around the world is trying to deal with. Looking at the eye surgeon example there seem to be several moving parts to these stories, ones which would yield to some entrepreneurial business thinking.

Firstly, a surgeon has to ask his/her self whether they can do their work more efficiently. Here I mean at the level of the core work – fixing a cataract say. The answer seems to be a resounding yes – procedures that take 15 minutes for one person can be done in half the time, maybe 10% of the time with skill and dedication to continuous improvement. I discovered lots of great examples of process innovation by surgeons. This innovation extended to other processes within the ‘total solution’ they are providing such as how things are managed pre and post op. I got the feeling that if every surgeon could move closer to some benchmark performance on all aspects then there is a huge latent capacity that could be freed up. Not only that but dedication to the tenets of process improvement and quality could assuage surgeons’ worries that they were taking risks with patient health. Of course many doctors work within perverse incentive systems that penalise continuous improvement….. exactly the thing that politicians are trying to tackle within the bureaucracies that are today’s modern health systems.

Meanwhile there are some real parallels with entrepreneurs – the biggest being that you’ve actually got to want to grow in either expertise or activity level. Once you’ve really committed to growth and accepted the personal risk it entails then a whole raft of possibilities open up. Maybe our health systems should be looking for those surgeons who really want to go for it, much like governments try to identify fast growth businesses?